超声引导下经皮引流术在儿童胰腺炎中的临床应用  

Clinical application of ultrasound-guided percutaneous catheter drainage in children with pancreatitis

作　　者：郭泓伶 张明满[1] 戴小科[1] 熊强[1] Guo Hongling;Zhang Mingman;Dai Xiaoke;Xiong Qiang(Department of Hepatobiliary Surgery,Children′s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院肝胆外科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿童代谢与炎症性疾病重庆市重点实验室,重庆400014

出　　处：《中华实用儿科临床杂志》2025年第1期17-20,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家临床重点专科建设项目(国卫办医政函[2024]189号)。

摘　　要：目的探讨超声引导下经皮引流术在小儿胰腺炎中的应用,总结其适应证,并探讨手术的有效性和安全性。方法回顾性病例分析。收集2018年9月至2023年1月重庆医科大学附属儿童医院收治的18例行超声引导下经皮引流治疗的患儿临床资料。其中男10例,女8例,年龄1岁4个月至15岁9个月。病因包括:创伤性胰腺炎9例,急性胰腺炎8例,复发性胰腺炎1例,病程1 d至5个月。手术指征包括:胰周液体积聚合并感染、腹膜炎,胰腺假性囊肿,胰周液体积聚进行性增多或合并压迫症状。收集患儿的临床信息,并统计引流部位、引流情况以及穿刺技术,穿刺成功率,穿刺并发症等资料。结果18例患儿共行19次引流术,均穿刺引流成功。无穿刺损伤、引流管阻塞、引流管感染等并发症发生,术后第1天引流量100~1010 mL。术后置管中位时间29(6~93)d。术后1例发生引流管移位,1例进展为慢性胰腺炎,其余患儿均达临床治愈,拔除引流管,术后未发生严重近远期并发症。结论超声引导下经皮引流术是儿童急性胰腺炎有效的治疗方法,具有效果好,操作简单,安全性高,创伤小等优势。ObjectiveTo investigate the clinical application of ultrasound-guided percutaneous catheter drainage in the management of pediatric pancreatitis,delineate the indications,and assess the efficacy and safety of the procedure.MethodsA retrospective case analysis.Eighteen patients who underwent ultrasound-guided percutaneous drainage at Children′s Hospital of Chongqing Medical University from September 2018 to January 2023 were conducted.The cohort comprised 10 males and 8 females aged 1 year 4 months to 15 years and 9 months.The causes of disease were traumatic pancreatitis(9 cases),acute pancreatitis(8 cases),and recurrent pancreatitis(1 case).The disease duration ranged from 1 day to 5 months.The indications for the procedure included acute peripancreatic fluid collection with infection and peritonitis,pancreatic pseudocyst,progressive increase of acute peripancreatic fluid collection,or compression symptoms.Patients′clinical data,including drainage site,drainage condition,puncture technique,puncture success rate and puncture complications,were collected and analyzed.ResultsNineteen drainage procedures were all successfully performed on the 18 children,and no puncture injury,drainage tube obstruction,drainage tube infection,and other complications were observed.Postoperative drainage volume on the first day ranged from 100 mL to 1010 mL.Postoperative catheterization time spanned from 6 to 93 days,with a median of 29 days.One patient experienced drainage tube displacement after surgery,and one patient progressed to chronic pancreatitis.The remaining patients achieved clinical cure and had their drainage tubes removed.No serious short-term or long-term complications were noted postoperatively.ConclusionsUltrasound-guided percutaneous drainage emerges as an effective therapeutic approach for children with acute pancreatitis,offering advantages such as favorable efficacy,straightforward operation,high safety,and minimal trauma.

关 键 词：儿童 急性胰腺炎 外引流 

分 类 号：R725.7[医药卫生—儿科]